Smart pill dispenser

ABSTRACT

The medication dispensing assembly includes a housing having an interior. A medication bottle is disposed in the interior with its cap assembly facing vertically downwardly. The cap assembly includes outer, middle, and inner pieces. The outer and inner pieces are fixed with one another, and the middle piece is fixed with the bottle. A drive unit is disposed in the interior of the housing and is configured to rotate the bottle and the middle piece of the cap assembly about a vertical axis. The three pieces of the cap assembly have respective medication openings, and rotating the bottle causes individual pills to travel first from the bottle into the inner piece, then into the middle piece, then around the vertical axis, and then outside of the cap assembly through the medication opening of the outer piece.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims priority to U.S. Provisional Patent App. No.63/087,345, filed on Oct. 5, 2020, and entitled “SMART PILL DISPENSER,”the entire disclosure of which is hereby incorporated herein byreference.

BACKGROUND 1. Field

The present disclosure is related generally to a medication dispensingdevice which contains multiple different types of pills and can dispensethose pills to a user.

2. Related Art

Many pharmaceutical regimens require a user to take multiple differenttypes of medications at different times. Generally, greater thevariation in the dosing events and/or the greater the number ofdifferent medications leads to diminished medication compliance. Inother words, the more complicated a dosing regimen is, the less likelyit will be correctly followed by the user. To counteract this problem,some products have been developed to improve medication compliance.

One known product which seeks to improve medication compliance is a pillcontainer which includes a plurality of individual chambers which cancontain different medications all in one container and which can bemanually opened and closed. However, a few known problems with thisproduct are that it is cumbersome to load and may not greatly improvecompliance because the user may simply forget to take a dose. Anotherproblem with this product is that in some jurisdictions, medications canonly be transported in containers, which are labeled to identify whatmedications are contained therein. Such labels are not common in theseknown types of multi-chambered pill containers.

SUMMARY

An example embodiment of a medication dispensing assembly for dispensingmedications from at least one medication bottle to a user is described.The medication dispensing assembly can include a housing having aninterior; a medication bottle including a receptacle and a cap assemblyand disposed in the interior with the cap assembly facing verticallydownwardly; the cap assembly comprising at least three pieces includingan outer piece and a middle piece and an inner piece, the outer andinner pieces being fixed with one another, the middle piece being fixedwith the receptacle, and each of the outer and middle and inner piecesof the cap assembly having at least one medication opening; a drive unitdisposed in the interior of the housing and configured to engage thereceptacle of the medication bottle to rotate the receptacle and themiddle piece of the cap assembly relative to the outer and inner piecesof the cap assembly and about an axis which extends through themedication bottle; and the at least one medication opening in the outerpiece of the cap assembly being circumferentially offset from the atleast one medication opening in the inner piece such that rotation ofthe receptacle and the middle piece causes individual pills to travelfirst from the receptacle into the at least one medication opening ofthe inner piece, then into the at least one medication opening of themiddle piece, then around the axis, and then outside of the cap assemblythrough the at least one medication opening of the outer piece.

In an example embodiment, the medication dispensing assembly may furtherinclude a carousel disposed in the interior of the housing and having aplurality of openings and the cap assembly being received in one of theopenings.

In an example embodiment, the axis of the medication dispensing assemblycoaxial with the bottle axis or generally aligned with a bottle axis. Acarousel can be positioned the interior of the housing and is rotatableabout a carousel axis which is spaced from and parallel with the bottleaxis to move the medication bottles through a plurality of zones withinthe interior of the housing.

In an example embodiment, the medication dispensing assembly furtherincludes a plurality of medication bottles and a plurality of capassemblies received in the plurality of openings of the carousel.

In an example embodiment, the medication dispensing assembly further hasone of the zones being a dispensing zone.

In an example embodiment, the drive unit includes at least one drivewheel that is configured to engage with and rotate the receptacle todispense the medication.

In an example embodiment, the one of the zones is an inspection zonewith at least one sensor that is configured to analyze the medicationbottle to automatically determine a contents of the medication bottle.

In an example embodiment, the medication dispensing assembly includes astaging zone positioned to receive medications dispensed from the atleast one cap assembly.

In an example embodiment, the staging zone includes at least one sensorand at least one gate and wherein the gate is configured to only open toallow the medications in the staging zone to be dispensed out of thehousing in response to a confirmation that the medications in thestaging zone have been requested by a user.

In an example embodiment, the medication dispensing assembly includes amedication packaging including a plurality of pouches containingmedications, the medication packaging extending over the staging zones,and a cutting device for opening the pouches to dispense the medicationscontained in the pouches into the staging zone.

In an example embodiment, the medication dispensing assembly furtherincludes a plurality of pill cups disposed in the interior of thehousing and containing medications; and a picking mechanism configuredto engage individual ones of the pill cups and dispense the medicationscontained in the pill cups into the staging zone.

A method of dispensing a medication from a bottle in a medicationdispensing device is described herein. The method can include the stepsof inserting a bottle that has a receptacle and a cap assembly into themedication dispensing device such that the cap assembly facesdownwardly, the cap assembly including an inner piece and a middle pieceand an outer piece, the inner and outer pieces being fixed with oneanother, the middle piece being fixed with the receptacle, and each ofthe pieces of the cap assembly having at least one medication opening;and rotating the receptacle and the middle piece relative to the outerpiece and the inner piece to channel a medication from the medicationbottle sequentially through the at least one medication opening in theinner piece, then through the at least one medication opening in themiddle piece, and then out of the cap assembly through the at least onemedication opening in the outer piece.

In an example embodiment, the dispensing includes the outer piece is anouter cap and the middle piece is an inner cap that is received in theouter cap and wherein the inner piece is a disk that is received in theinner cap.

In an example embodiment, the dispensing includes the at least onemedication opening in the disk is circumferentially offset from themedication opening in the outer cap such that the medication must travelin the at least one medication opening in the inner cap around arotational axis before exiting the cap assembly through the at least onemedication opening in the outer cap.

In an example embodiment, the dispensing further includes the step ofreceiving the medication dispensed out of the cap assembly into astaging zone of the medication dispensing device.

In an example embodiment, the method further includes the step ofanalyzing the medication in the staging zone and further including thestep of dispensing the medication out of the staging zone only inresponse to a positive verification of the medication in the stagingzone.

In an example embodiment, the dispensing includes the step of insertingthe bottle into the medication dispensing device includes inserting thebottle into a carousel and further including the steps of: rotating thecarousel to bring the bottle into an inspection zone; inspecting acontents of the bottle with at least one sensor; and rotating thecarousel to bring the bottle into a dispensing zone prior to the step ofrotating the receptacle and middle piece of the cap assembly

A cap assembly for singulating and dispensing a medication from a bottlein a medication dispensing device is described and can include an outerpiece; a middle piece that is at least partially received within theouter piece; an inner piece that is received in the middle piece, theinner piece being fixedly attached with the outer piece; the middlepiece being rotatable relative to the outer and inner pieces about anaxis; each of the outer piece and the middle piece and the inner piecehaving at least one medication opening sized to allow a medication passtherethrough; and the at least one medication opening in the inner piecebeing circumferentially spaced from the at least one medication openingof the outer piece such that the medication openings in the outer pieceand the middle piece and the inner piece cannot be aligned with oneanother and such that rotation of the middle piece causes individualmedications to travel first into the at least one medication opening inthe inner piece then into the at least one medication opening in themiddle piece, then around the axis and then outside of the cap assemblythrough the at least one opening in the outer piece.

In an example embodiment, the cap assembly includes the outer piecebeing an outer cap and the middle piece being an inner cap that isreceived in the outer cap and wherein the inner piece is a disk that isreceived in the inner cap.

In an example embodiment, the cap assembly includes one of the outer capand the disk having a probe which extends through the inner cap andwhich is fixedly attached with the other of the outer cap and the disk.

In an example embodiment, the inner cap includes inner threads forthreading into engagement with the bottle.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features and advantages of the disclosure will becomemore readily appreciated when considered in connection with thefollowing description of the presently preferred embodiments, appendedclaims and accompanying drawings, in which:

FIG. 1 is a perspective elevation view showing a first embodiment of adispensing device with a lid of the dispensing device being in a closedposition;

FIG. 2 is a perspective elevation view of the dispensing device of FIG.1 and showing the lid in an open position;

FIG. 3 is a cross-sectional view of the dispensing device of FIG. 1 ;

FIG. 4 is another cross-sectional front view of the dispensing device ofFIG. 1 ;

FIG. 5 is an enlarged view showing a dispensing zone in an interior ofthe dispensing device of FIG. 1 ;

FIG. 6 is an exemplary medication bottle including a cap assembly whichcan cooperate with a carousel in the dispensing device of FIG. 1 ;

FIG. 7A is a top elevation view of an outer cap of the cap assembly onthe bottle of FIG. 6 ;

FIG. 7B is a front elevation view of the outer cap of FIG. 7A;

FIG. 8A is a top elevation view of an inner cap of the cap assembly onthe bottle of FIG. 6 ;

FIG. 8B is a front elevation view of the inner cap of FIG. 8A;

FIG. 8C is a perspective elevation view of the inner cap of FIG. 8A;

FIG. 9A is a top elevation view of a disk of the cap assembly of thebottle of FIG. 6 ;

FIG. 9B is a front elevation view of the disk of FIG. 9A;

FIG. 10 is a cross-sectional view of the bottle of FIG. 6 ;

FIG. 11 is a partially cross-sectional view showing a bottle in adispensing zone of the dispensing device of FIG. 1 ;

FIG. 12 is a fragmentary view of a dispensing device constructedaccording to a second embodiment of the present disclosure;

FIG. 13A is a top elevation view of a pill cup that can be disposed inthe dispensing device of FIG. 12 ;

FIG. 13B is a front elevation view of the pill cup of FIG. 13A;

FIG. 13C is a cross-sectional view of the pill cup of FIG. 13A;

FIG. 14A is a top and fragmentary view of the dispensing device of FIG.12 ;

FIG. 14B is an enlarged view of a portion of the dispensing device ofFIG. 14A and focusing on a cutter;

FIG. 15 is a front and fragmentary view of the dispensing device of FIG.12 ;

FIG. 16A is a side and fragmentary view of the dispensing device of FIG.12 ;

FIG. 16B is a side elevation view illustrating a gantry holding a pillcup prior to a cutting operation;

FIG. 16C is a side elevation view illustrating the gantry holding thepill cup during a cutting operation;

FIG. 17A is a schematic view showing a communication system in which thedispensing device can operate;

FIG. 17B is a schematic view showing a pharmacy that may be the pharmacyin

FIG. 17A;

FIG. 18 is a schematic view of the electrical system of the dispensingdevice;

FIG. 19 is a flow chart illustrating the steps of an exemplary methodaccording to one aspect of the subject disclosure;

FIG. 20 is a flow chart illustrating the steps of an exemplary methodaccording to another aspect of the subject disclosure;

FIG. 21 is a flow chart illustrating the steps of an exemplary methodaccording to yet another aspect of the subject disclosure; and

FIG. 22 is a flow chart illustrating the steps of an exemplary methodaccording to still another aspect of the subject disclosure.

DESCRIPTION OF THE ENABLING EMBODIMENT

Referring to the Figures, wherein like numerals indicate correspondingparts throughout the several views, one aspect of the present disclosureis related to a medication dispensing device 20 that is configured toautomatically dispense one or more different types of solid medicationsfor a user (e.g., a patient, a caregiver or the like). The dispensingdevice 20 is conveniently contained within a compact package, which canbe stored in a convenient location within a user's home, such as on akitchen counter, under a shelf, or on a bedside table. The medicationsare frequently hereinafter referred to as pills 22; however, it shouldbe appreciated that other types of medications that can be singulatedmay be employed. Such medications may include, for example, solidmedications (such as tablets, gel caps, capsules or the like, e.g.,non-liquid medicines) or non-solid medications in containers (such assingle use eye drop containers or other single use liquid medications).

As discussed in further detail below, in operation, the dispensingdevice 20 automatically singulates and dispenses pills 22 directly outof their respective original prescription containers either according toa preset schedule or an on-demand request by the user. This improvesmedication compliance by allowing the user to conveniently store a largesupply of different pills 22 in their original medication containers asingle, convenient device 20, which not only stores the pills 22 in asorted manner but also assists the user with their medication schedulethereby preventing either missed doses or double doses. As alsodiscussed in further detail below, the medication dispensing device 20is a smart device in that it knows what types of medications arecontained within it and the quantities of those medications and is ableto communicate this and other information to a user's external device 24(such as a smart phone, a tablet, a personal, computer, a smart watch, adedicated unit, a voice assistant, a host, or any suitable type ofelectronic device) and is able to receive information from the externaldevice 24. The various containers in the dispensing device 20 maycontain a range of different types of pills 22 including bothprescription and non-prescription medications. The dispensing device 20may also communicate with other authorized devices, e.g., a caregiverdevice, a family member device and the like. This can work to notify theother authorized device of the dispensing of the pills from the device20.

In an example embodiment, singulating refers to the ability to remove asingle one of a pill from a container or reservoir in the device 20. Thesingulating action can be repeated to dispense more than one pill.

Referring now to FIGS. 1 and 2 , the dispensing device 20 includes ahousing 26 with an open interior, which contains the medicationscontainers, and a dispensing tray 28. A lid 30 is hingedly connectedwith the housing 26 and can be manually or automatically opened andclosed. The housing 26 and lid 30 are sealed against one another toblock all or substantially all outside light from entering the openinterior, thereby controlling the environment within the open interiorto improve verification of the medications contained within thedispensing device 20, as discussed in further detail below. The lid 30is shown on the top of the housing but may also be positioned on theside or rear of the housing 26.

The lid 30 has a top surface that includes machine-to-human interactiondevices or human machine interface (HMI), which may include a speaker32, a microphone 34, and a first display screen 36. In some embodiments,the lid 30 also includes one or more buttons (not shown) which provideanother means by which a user can communicate with the dispending device20. A second display screen 38 is attached with a lower surface (innersurface when lid is closed) of the lid 30 so that the user can alsointeract with the dispensing device 20 when the lid 30 has been opened.The first and second display screens 36, 38 may be, for example, liquidcrystal display (LCD) or light emitting diode (LED) displays andpreferably include touch screen interfaces. However, any suitably screentypes may be employed. The lid may further include a camera 39 which mayallow the user to conduct a videoconference appointment with a medicalcare provider through the dispensing device 20.

The speaker 32; the microphone 34; and the first and second displayscreens 36, 38 are a few ways (other ways discussed in further detailbelow) for a user to interact with the dispensing device 20. Suchinteractions may allow the user to, inter alia, check the quantities ofthe medications contained in the dispensing device 20, request amedication, adjust an automatic dispensing schedule, and/or pair thedispensing device 20 with an external device 24. When the dispensingdevice 20 determines that the medication count in any of the medicationcontainers is below a predetermined threshold (e.g., five pills or atime period, such as a week or less, or two weeks or less of medicationremains), an alert can be displayed on the first display screen 36 (ifthe lid 30 is closed) or the second display screen 38 (if the lid 30 isopen), or the alert can be broadcast through the speaker 32. When thelid 30 is open, the second display screen 38 can show instructions onhow to accomplish a task in the interior of the housing 26, e.g., how toproperly insert or remove medication containers. In an exampleembodiment, the inner, second display screen 38 is off whenever the lid30 is closed. This can be performed by a switch in the housing that isengaged to turn on the display 38 with the lid closed onto the remainderof the housing.

One type of medication container that the dispensing device 20 is ableto hold and dispense is pills 22 from is a medication bottle 40.Specifically, the interior of the housing 26 contains a carousel 42 witha plurality of through openings that are shaped and sized to hold aplurality of bottles 40 in an upside-down orientation such that the caps44 of the bottles 40 all face vertically downwardly. The carousel 42 ispreferably configured such that proper insertion of the cap 44 into oneof the through openings of the carousel 42 results in an audible“snapping” sound to provide the user with a positive affirmation thatthe insertion was successful. In an example embodiment, the device caninclude light curtains therein that sense when a medication bottle isinserted into the openings in the body of the carousel 42. The emittersand detectors of the light curtain can be mounted on the housing anddirect a light beam (which includes infra-red emissions) toward thecarousel. The caps 44 are held in the respective openings of thecarousel 42 in a detachable manner such that any of the bottles 40 canbe manually and individually removed from the dispensing device 20,e.g., when the medication in the bottle 40 is depleted. In the exemplaryembodiment, the carousel contains five separate openings for holdingfive (5) different bottles 40, which could contain either the same typesor different types of medications. In other embodiments, the housingcontains more or fewer than five (5) openings.

During operation of the dispensing device 20, the carousel 42 rotatesabout a centrally located first axis to move the bottles 40 mountedthereon between different zones (including an inspection zone 46 and adispensing zone 48) within the interior of the housing 26. The carousel42 is preferably driven in rotation by an electric motor (not shown)which can rotate the carousel 42 about the first axis in eitherrotational direction (clockwise or counter-clockwise). In an exampleembodiment, the first axis is vertical and the carousel rotates in ahorizontal plane or orthogonal to the first axis. Additional zones, suchas a loading/unloading zone may also be included.

Referring now to FIGS. 4 and 5 , the inspection zone 46 includes aplurality of electronic components which are configured to automaticallydetermine and/or verify the contents of a bottle 40. Specifically, inthe exemplary embodiment, the inspection zone 46 includes a plurality ofcameras 50 positioned at different locations, a plurality of lightsources 52 which can project light in different directions, a codescanner 54, a label scanner 56, an ultrasonic sensor 58, and an agitator60. The code and label scanners 54, 56 could be separate components fromone another and from the cameras 50 or could be combined together orcould be incorporated into one or more of the cameras 50. The agitator60 is configured to lift the bottle 40 out of the opening of thecarousel 42 and pivot the bottle 40 about a pivot point into theposition shown in FIG. 5 . The agitator 60 includes a built-in scale tomeasure the weight of the bottle 40 including the medications containedtherein. As explained in further detail below, in use, the code andlabel scanners 54, 56 allow the dispensing device 20 to automaticallydetermine the contents of the bottle 40. Based on the measured weight bythe agitator 60 and known weights of an empty bottle 40 and of each pill22 contained therein (once the medication type has been determined), thedispensing device 20 is thus able to determine a medication count forthe bottle 40. Both the type and quantity of the pills 22 in the bottlecan also be verified using images captured by the cameras 50 pointed ata translucent portion of the bottle and by a sonogram generated by theultrasonic sensor 58.

In operation, when a bottle 40 is placed into the carousel 42, thecarousel 42 is rotated about the first axis to bring that bottle 40 intothe inspection zone 46. Next, the agitator 60 engages with and lifts thebottle 40 out of the carousel 42 and measures its weight. The lightsources 52, the cameras 50, the code scanner 54, the label scanner 56,and the ultrasonic sensor 58 are all then activated to scan both anouter surface of the bottle 40 and the contents of the bottle 40.Specifically, the code and label scanners 54, 56 scan the outer surfaceof the bottle 40 for a label and/or a machine readable code (such as abar code or a QR code) with data related to the contents of the bottle40 is. The cameras 50 also directly view the pills 22 within the bottle40, and the images generated by the cameras 50 can be scanned todetermine the shape, size, and etchings of the pills 22. The ultrasonicsensor 58 scans the bottle 40 to generate a sonogram of the bottle 40and its contents. The dispensing device 20 compares the weightmeasurement sensed by the agitator 60, the images captured by thecameras 50, and the sonogram generated by the ultrasound sensor 58against an artificial intelligence database to verify both the type andquantity of pills 22 contained in the bottle 40. The artificialintelligence database is preferably maintained in a remote server and isbe periodically downloaded to a memory 1802 (shown in FIG. 18 anddiscussed in further detail below) in the dispensing device 20 toimprove performance of the dispensing device 20. The dispensing device20 also preferably uploads images and sonograms which are generated bythe cameras 50 and the ultrasound 58 to the database to improve thedatabase.

The agitator 60 may be activated to shake the bottle 40 and its contentsif any of the images generated by the cameras 50 and/or if the sonogramgenerated by the ultrasound sensor 58 is not clear. Once the imaging andsensing operation is completed and the pills 22 have been verified, theagitator 60 returns the bottle 40 to the carousel 42, and the carousel42 may be rotated to move the bottle 40 out of the inspection zone 46.The automatic detection and determination of the pill 22 in the bottle40 allows for a strong user experience, which promotes improvedadherence, safety, and user satisfaction. The agitator 60 may also beused to assist with singulating pills 22 for dispensing.

The agitator 60 can also shake the bottle to move the contents into anew position and the imager can capture multiple images of the contentsin the bottle. These additional images can be used in the predictivemodel for training and validation operations. These additional images,e.g., photographs, provide filed data of the bottles with a knownquantity of pills therein. The dispensing device can use its agitator 60to change the position of the pills and then take multiple images. Alarger data set leads to better operation of the predictive models andmay improve operation of all dispensing devices collectively based on animproved predictive model.

As discussed in further detail below, the cap 44 on the bottle 40 isconfigured to singulate and dispense pills 22 only when the bottle 40 isrotated by the dispensing device 20 when the bottle 40 is in thedispensing zone 48. As shown in FIG. 11 , the dispensing zone 48 of theexemplary embodiment includes at least one drive wheel 62 which, inoperation, directly engages with an outer surface of the bottle 40 androtates the bottle 40 through the force of friction between the drivewheel 62 and the bottle 40. When the bottle 40 is brought into thedispensing zone 48, either the drive wheel(s) 62 can be moved intocontact with the bottle 40 or the bottle 40 can be moved into contactwith the drive wheel(s) 62 or both. In the exemplary embodiment, thedispensing zone 48 includes two drive wheels 62. However, in otherembodiments, the dispensing zone 48 includes only a single drive wheel62 or three or more drive wheels 62. The dispensing zone 48 may alsoinclude one or more undriven wheels to counter any radial force beingapplied on the bottle 40 by the drive wheel(s) 62. The drive wheels 62are preferably driven in rotation by electric motors (not shown).

Referring back to FIG. 3 , the dispensing device 20 further includes astaging zone 64 which is located directly beneath the dispensing zone 48for catching pills 22 dispensed by the bottle 40 in the dispensing zone48 and conveying those pills 22 to the dispensing tray 28 only after afinal verification that the quantity and type of pills 22 released fromthe bottle 40 is correct. Specifically, the staging zone 64 includes agate 66 which remains closed between dispensing events and can beselectively opened to allow the pills 22 to continue to the dispensingtray 28. The staging zone 64 includes a camera 68 and/or other sensor(s)which scans the medications 22 dispensed out of the bottle 40 while thegate 66 is closed. The dispensing device 20 then compares the images orinformation gathered by the camera 68 and/or other sensors against thedatabase and against the medication that was requested (eitherautomatically according to a predetermined schedule or on demand) tocomplete the final verification process. The dispensing device 20 onlyopens the gate 66 to allow the pills 22 to be released to the dispensingtray 28 upon confirmation by the dispensing device 20 that the dosage iscorrect. If the types of pills 22 in the staging zone 64 is not corrector cannot be verified or the quantity of pills 22 in the staging zone 64is too high, then the dispensing device 20 may display an alert on oneof the display screens 36, 38 or sound an alert through the speaker 32.If the quantity of pills 22 in the staging zone 64 is too low, then thedispensing device 20 can re-activate the drive wheel 62 in thedispensing zone 48 to dispense one or more additional pills 22 from thebottle 40 into the staging zone 64.

The dispensing device 20 further includes a camera 69, or another typeof sensor, adjacent the dispensing tray 28 for verifying that the userhas retrieved the pills 22 from the dispensing device 22. If retrievalis not detected after a predetermined time, then the dispensing device20 may automatically send an alert to the user. The alert could be, forexample, visual on the first display screen 36, audible through thespeaker 32, or it could be sent directly to the user's external device24.

The dispensing device 20 further includes a plurality of caps 44 whichare configured to thread onto (or otherwise engage with) an originalmedication bottle 40 so that the original bottle 40 can be used with thedispensing device 20, which is in contrast to other known deviceswherein the medication must be removed from the bottle. In many cases,the cap 44 can be fitted directly with an original medication bottle 40by simply unthreading the original cap and threading the cap 44 onto thebottle 40 in its place. For example, FIG. 6 shows one such cap 44 asfitted onto an original medication bottle 40. Allowing the pills 22 toremain in their original bottles 40 may also enhance convenience for auser by allowing the user to travel with the medications contained inthe dispensing device 20 in jurisdictions that have laws which strictlygovern the labeling of prescription medications. Further, the addedconvenience by not requiring the user to transfer the pills 22 out of anoriginal bottle 40 and into either a different container or directlyinto the dispensing device 40 may improve safety, particularly for userswho have numerous and/or complex dosing regiments and for users who havelimited visual and/or cognitive functionality. Differently sized innercaps can accommodate and singulate differently sized and shaped pills.For example, a first inner cap may be configured to accommodate a firsttype of pill, and a second inner cap may be configured to accommodate asecond type of pill that is either larger or smaller than the first typeof pill.

As discussed above, the cap 44 is configured to singulate and dispensepills 22 out of the bottle 40 in response to rotation of the bottle 40in the dispensing zone 48 of the dispensing device 20. With referencenow to FIGS. 7-10 , to singulate and dispense the pills 22, the cap 44includes a total of three pieces: an outer cap 70, an inner cap 72, anda disk 74. The outer and inner caps 70, 72 each are generally cup-shapedwith an open top, a flat bottom, and a cylindrical side wall extendingaxially from the flat bottom. Although the outer and inner caps 70, 72have similar general shapes, the inner cap 72 has a lesser outerdiameter than the outer cap 70. This allows the inner cap 72 to benested within the outer cap 70 in a slip-fit manner, i.e., the fitbetween the outer and inner caps 70, 72 is loose. The disk 74 includes acentrally located probe 76 which extends axially through a similarlyshaped hole in the inner cap 72 and which is fixedly attached (such asthrough ultrasonic welding) with the outer cap 70. Thus, the outer cap70 and disk 74 are fixedly attached with one another via the probe 76,and the inner cap 72 is able to rotate relative to the outer cap 70 anddisk 74. The side wall of the inner cap 72 has female threads, which arevisible in FIG. 8C, that allow the inner cap 72 to be threaded onto thebottle 40, as discussed below. All three components of the cap 44 arepreferably made of a rigid polymeric material and are preferably madethrough respective injection molding operations.

The disk 74 has a single pill opening 78 that is spaced radially fromthe second axis and that is shaped to pass only a single pill 22 throughthe disk 74 at a time. The shape and size of the pill opening 78 thusdepends on the shape and size of the pills 22 contained in the bottle40. The inner cap 72 has a plurality of similarly shaped pill openings80 which are spaced apart from one another and which are each sized toonly receive a single pill 22 from the pill opening 78 in the disk 74.The outer cap 70 has a single pill opening 82 that is circumferentiallyoffset from the pill opening 78 in the disk 74, i.e., the pill openings78, 80, 82 of the disk 74, inner cap 72, and outer cap 70 respectivelycannot be aligned with one another. Due to the single pill size of eachof these pill openings 78, 80, 82, it is thus only possible to dispensea single pill 22 through the cap 44 at a time.

In operation, to dispense a pill 22 from the bottle 40 being held by thecarousel 42 in the dispensing zone 48, the drive wheels 62 are engagedwith an outer surface of the bottle 40 and are activated to rotate thebottle 40 along with the inner cap 72. If an open pill opening 80 of theinner cap 72 is brought into alignment with the pill opening 78 in thedisk 74, then a pill 22 will fall under the influence of gravity intothe pill opening 80 of the inner cap 72. In a similar manner, whenrotation of the bottle 40 and the inner cap 72 about a bottle axisbrings a filled pill opening 80 in the inner cap 72 into alignment withthe pill opening 82 of the outer cap 72, then that pill 22 will fallunder the influence of gravity out of the cap 44 and downwardly into thestaging zone 64 (shown in FIG. 4 ). As discussed above, a finalinspection is then performed on the pill 22 and any additional pills 22prior to dispensing to the dispensing tray 28.

The outer and inner caps 70, 72 are provided with cooperating rotationlimiting features 84 a, 84 b to allow the threading of the inner cap 72onto the bottle 40 without inhibiting the rotation of the inner cap 72relative to the outer cap 70 during the dispensing operation. In thisembodiment, the rotation limiting feature 84 a of the outer cap 70includes a plurality of teeth that are angled in one direction, and therotation limiting feature 84 b of the inner cap 72 includes a pluralityof teeth that are angled in an opposite direction. When threading thecap 44 onto the bottle 40, the teeth engage with one another to allowthe inner cap 72 to rotate with the outer cap 70 and thread onto thebottle 40.

Referring now to FIG. 12 , another exemplary embodiment of thedispensing device 1200 is generally shown with certain elements that aresimilar to or identical with the above-discussed embodiment beingremoved for clarity purposes. In this embodiment, in addition to bottles40, the dispensing device 1200 is also configured to automaticallydispense from two other types of original medication containers, namelyplastic pack pouches 1202 (or blister packs) and also from individualpill cups 1204.

In this embodiment, at least a portion of the staging zone 1264 has theshape of a funnel with a large catching end that faces towards thedispensing zone and which is sized to extend well beyond the peripheryof the dispensing zone for catching pills 22 dispensed from all of thebottles 40, the plastic pouches 1202, and the pill cups 1204. In otherwords, pills 22 from any of these containers 40, 1202, 1204 can all beautomatically dropped by the dispensing device 1200 into the largecatching end of the staging zone 1264 and ultimately dispensed out ofthe same dispensing tray 28.

The plastic pouches 1202 are all strung together in a single piece oftubing that is initially wound around a spool within a container 1206.In this embodiment, the container 1206 is external to the housing 26 butmay be enclosed within the housing 26 in other embodiments. Each pouch1202 may include one or more than one pill 22, and for pouches 1202 thatcontain multiple pills 22, they may be the same or different types ofmedications. The dispensing device 1200 includes a wind-up spool 1208which is located in the interior of the housing 26 on an opposite sideof the funnel-shaped portion of the staging zone 1264 from the container1206 such that the pouches 1202 must pass over the large catching end ofthe staging zone 1264 when travelling from the container 1206 to thewind up spool 1208.

To release the pills 22 from the pouches 1202, the dispensing device1200 includes a cutting device 1210 (such as a blade) which ispositioned directly above the large catching end of the staging zone 64.In use, the wind-up spool 1208 is rotated by an actuator (such as anelectric motor) to position one of the pouches 1202 directly over thelarge catching end of the staging zone 64. Next, an actuator (not shown)is activated to urge the cutting device 1210 against the pouch 1202 andcut a slit into only a lower surface of the pouch 1202 withoutseparating the pouch 1202 from the tubing. Any pills 22 contained in thepouch 1202 will fall under the influence of gravity into the stagingzone 1264 for final inspection prior to dispensing out of the dispensingdevice 1200 via the dispensing tray 28. As shown in FIG. 15 , thedispensing device 1200 further includes a pair of scanners 1212 (suchcameras) which are located above and below the tubing containing thepouches 1202 upstream of the cutting device 1210 for scanning anylabeling on the pouches 1202 and/or directly scanning the pills 22contained inside of the pouches 1202 prior to dispensing the pills 22.As shown in FIG. 14B, in an exemplary embodiment, a redirecting feature1265 is positioned immediately upstream of the cutting device 1210 tourge any pills away from the location of the cutting device 1210. In theexemplary embodiment, the redirecting feature is generally V or wedgeshaped. In other embodiments, the redirecting feature 1265 could belinear and angled relative to the direction of travel of the tubing withthe pouches 1202. In operation, the redirecting feature 1265 may presson the tubing to urge the pills away from the center of their respectivepouches 1202. In some embodiments, the cutting device may be positionedabove the tubing and may cut the pouches from the top and all the waythrough the tubing. In another embodiment, the redirecting feature mayinclude one or more rollers that are configured to “squeeze” the pillsfrom one side of a pouch to the other. Once the cutting device cuts thepouch, then another set of rollers can force the pills in the directionof the cut and out of the pouch.

Referring now to FIGS. 13A-C, an exemplary pill cup 1204 is generallyshown. The pill cup 1204 has an open top and a closed base and has ashape which allows it to nest with other pill cups 1204 so that multiplepill cups 1204 can be packaged together in a compact manner eitherbefore they are filled or after they are emptied. Specifically, a baseof the pill cup 1204 has a first dimension (e.g., a circular footprintwith a first diameter) and a top of the pill cup 1204 has a seconddimension (e.g., circular footprint with a second diameter) that islarger than the first dimension. The pill cup 1204 has a sloping sidewall which extends from the smaller base to the larger top. In theexemplary embodiment of FIG. 13B, a removable lid 1300 made of a filmmaterial is adhesively attached with the top of the pill cup 1302 forcontaining the pills 22 within the pill cup 1302. The removable lid 1300preferably contains a label with contents information and dosinginstructions. The lid 1300 includes a tab 1302 which can be graspedeither by a user or by a machine to peel the lid 1300 away from the pillcup 1204.

The pill cups 1204 may be configured to provide a volume within whichthe desired number of pills 22 may be dispensed without excessive wastedvolume. Specifically, the pill cups 1204 are preferably sized to have aninterior volume which is large enough to hold all of the pills 22necessary for a single dosing event. Thus, each pill cup 1204 maycorrespond to a scheduled dosing event in a multi-drug regimen. By wayof example and not limitation, the approximate dimensions of the pillcup 1204 may be 1.25 to 1.5 inches in diameter and 1 to 1.5 inches deepfor small cups and 1.5 to 2 inches in diameter and 2.25 inches deep forlarge cups. The pill cups 1204 are preferably constructed using a rigidor semi-rigid material, such as various types of polymer or plasticwhich are capable of maintaining the form of the pill cup 1204 toprotect the pills 22 contained therein in a range of environments,including in a pharmacy where the pill cup 1204 is filled and duringshipment from the pharmacy to the user. By way of example, the materialmay include food packaging materials, such as polyethylene. For example,the material may be made from recyclable polypropylene #5 plasticsimilar to a yogurt or butter container or cellulose polypropylene. Thematerial may be a multi-layer blend of polymers. The thickness of theside walls is preferably chosen to provide the pill cup 1204 with thedesirable durability characteristics. A desirable characteristic may beto avoid an overly strong container which may indicate to the userwasted material. Thus, for example, the pill cup 1204 may be constructedto be weak enough for a person to easily squeeze the pill cup 1204 inthe person's hand to collapse the pill cup 1204 when its lid 1300 hasbeen removed and it has been emptied, yet strong enough to maintain itsform prior to removal of the lid 1300.

Referring now to FIG. 15 , the pill cups 1204 are disposed within aplurality of openings on a tray 1214 that is located in the interior ofthe housing 26. Each pill cup 1204 may include one or more pills 22 (notshown in this Figure). For pill cups 1204 that contain multiple pills1204, the pills 22 may the same type of medication or different types ofmedications, i.e., a single pill cup 1204 may be customized to includeall of the medications required for a single dosing event. The tray 1214is removeable from the interior of the housing 126 either through anopening exposed when the lid 30 of the housing 26 is opened (see FIG. 2) or through a door in a side wall of the housing 26 so that the tray1214 can be refilled with additional pill cups 1204. The pill cups 1204may be arranged into the tray 1214 according to a known pattern, e.g.,the pill cups 1204 can be arranged according to a pattern which is basedon the chronological order of dosing events. In some embodiments, thecontents of the pill cups 1204 can be input into the dispensing device1200 either manually or automatically, for example, by scanning the pillcups 1204 either prior to or after tray 1214 is placed into thedispensing device 1200.

As shown in FIG. 12 , the dispensing device 1200 includes a pickingmechanism 1216 which can individually lift pill cups 1204 out of thetray 1214 and deposit either just the pills 22 contained in the pillcups 1204 or the full pill cups 1204 into the funnel-shaped portion ofthe inspection zone 46. Preferably, the picking mechanism 1216 engageseach pill cup 1204 by its respective rim while leaving at least aportion of the lid 1300 so that the information contained on the lid1300 can be scanned prior to dispensing the pills 22 into the inspectionzone 146 of the dispensing device 120.

In the exemplary embodiment, the picking mechanism 1216 is athree-dimensional gantry 1216 which includes a gripping mechanism 1218that can engage and lift any one of the pill cups 1204 out of the tray1214 and carry that pill cup 1204 to a position directly above the largecatching end of the staging zone 1264. Either when the pill cup 1204 isdirectly above the inspection zone 1204 or prior to the pill cup 1204reaching the position above the staging zone 1264, a scanner 1220 (suchas a camera) scans the lid 1300 of the pill cup 1204 to confirm that thecontents of the pill cup 1204 matches the dispensing instructions. Thegantry 1216 then releases the full pill cup 1204 into the staging zone.The gantry 1216 includes a frame and one or more actuators which areable to move the gripping mechanism 1220 in three-dimensions, namely, Xand Y horizontal directions and a Z vertical direction.

In operation, when a particular pill cup 1204 is requested (either ondemand or according to an automatic dispensing schedule), the gantry1216 moves the gripping mechanism 1218 in the X and Y directions to alocation directly above the requested pill cup 1204. Next, the grippingmechanism 1218 is lowered in the Z-direction and is actuated to engagewith the pill cup 1204. The gripping mechanism 1218 then lifts the pillcup 1204 out of the tray 1214 and to a location above the funnel-shapedstaging zone 1264. The gantry 1218 is then actuated to move the pill cup1204 to the scanner 1220 which scans the lid 1300 to confirm that itcontains the correct contents. In this embodiment, the grippingmechanism 1218 releases the pill cup 1204 into the staging zone 1264. Inother embodiments, the lid 1300 of the pill cup 1204 is either removedor cut to dispense the pills 22 directly into the staging zone 1264without also dispensing the packaging of the pill cup 1204. For example,in one alternate embodiment, the cutting device 1210, or a separatecutting device, may be actuated to cut the lid 1300 such that the pills22 will fall out of the pill cup 1204 through the cut. In anotherembodiment, a peeling mechanism (not shown) may grab the tab 1302 on thelid 1300 and peel the lid 1300 away from the pill cup 1204. For example,in the embodiment of FIGS. 16B and 16C, the gantry 1218 brings the pillcup 1204 to a cutting device 1600, which cuts a bottom out of the pillcup 1204 to allow the pills 22 to fall out of the pill cup 1204 and intothe staging zone 64. The cutting device 1600 may be an ultrasonic cutteror any suitable type of cutting mechanism. During the cutting operation,the gantry 1218 may move the pill cup 1204 relative to the cuttingdevice 1600 or vice versa. In some embodiments, the gantry 1218 couldinvert the pill cup 1204 and the cutting device 1600 could cut the topof the pill cup 1204. In these embodiments, once the pill cup 1204 isemptied, the gantry 1216 may place it into a dispensing area of theinterior of the dispensing device 1200. In some embodiments, a roboticarm, such as a six-axis robotic arm could be employed in place of thegantry to lift the pill cups 1204 and either deposit the pill cups 1204directly into the staging zone 64 or to the cutting device 1600, whichcuts the pill cups 1204 to drop the pills 22 into the staging zone 64.

FIG. 17A is a schematic view showing an eco-system in which either ofthe dispensing devices 20, 1200 can operate. The dispensing device 20,1200 is electrically connected with the internet 1700 via a portal, suchas a router 1702 (wired or wireless) or the external device 24 orthrough any suitable internet gateway. Through the internet 1700, thedispensing device 20, 120 is able to communicate with a pharmacy 1706and with a pharmacy benefit manager 1708. Thus, the pharmacy 1706 andpharmacy benefit manager 1708 can monitor the dispensing of the pills 22out of the dispensing device 20, 1200 to monitor a user's compliance tohis or her medication schedule. In some embodiments, the pharmacy 1706and/or the pharmacy benefit manager 1708 can automatically order a newprescription in response to the quantity of that medication in thedispensing device 20, 1200 falling below a predetermined threshold. Thedispensing device 20, 1200 can also communicate with the external device24 or with a voice assistant 1710 (such as those sold by Google®,Amazon®, and Apple®) directly and/or via the router 1702.

The dispensing device 20 may use its communication functions, e.g.,audio, VOIP or text, to call a pharmacist device. When thiscommunication is established the dispensing device may encrypt thecommunication to ensure private communication. Such a communication canaddress medication concerns or questions. The communication functionscan include the display, the microphone and the speaker built into thedispensing device, each of which can be controlled by control circuitryand use transmission circuitry to communicate with remote devices. In anexample embodiment, the dispensing device may use its display to showvideo of the pharmacist (or nurse) speaking in real-time for a morepersonal interaction with the patient.

Additional devices may communicate with other devices parties in thecommunication system. The additional devices can be a payer device or aprescriber device. The payer device can be part of an adjudicationsystem or an insurance company system, The prescriber device may be partof a medical care facility or individual medical care provider computingsystem, may be the prescriber of the medication and the payer (such asinsurance company). These additional devices may be directly connectedor indirectly connected in which case the PBM or pharmacy could be anintermediary to the payer or prescriber devices.

For example, the user of the dispensing device 20, 1200 may interactwith the external device 24 to provide various voice commands. The voicecommands may indicate the user's desire to refill a prescription,dispense daily or periodic medications, or other suitable voicecommands. The external device 24 may communicate with the dispensingdevice 20, 1200 to provide data corresponding to the voice commands. Thedispensing device 20, 1200 may take action in response to receiving thedata from the external device 24. For example, the dispensing device 20,1200 may communicate with the pharmacy 1706 to refill a prescriptionbased on the data received from the external device 24. It should beunderstood that the dispensing device 20, 1200 may receive any suitabledata from the external device 24 and may take any suitable action inresponse to the data.

In some embodiments, the dispensing device 20, 1200 may include an inputdevice configured to receive audible signals. The input device mayinclude a microphone or other audio input device. The audible signalsmay include voice commands from the user (e.g., or caretaker and thelike), an audible indication from a mobile computing device (e.g., awearable device, a smart phone, and the like), any other suitableaudible signal, or a combination thereof. For example, the user mayprovide voice commands directly to the dispensing device 20, 1200 usingthe input device. In some embodiments, the input device may beconfigured to communicate with a device that can process the user'sbrain pattern activities such that the user can provide a demand for apill to the dispensing device 20, 1200 without any physical or audibleaction.

Additionally, or alternatively, the dispensing device 20, 1200 and/or amobile computing device that communicates with the dispensing device 20,1200 can provide reminders to the user to take medications according toa medication schedule that is either stored in the memory of thedispensing device 20, 1200 or remotely therefrom. The mobile computingdevice or the dispensing device 20, 1200 may generate an audible signalat a predetermined time (e.g., corresponding to a reminder to take aparticular mediation). The dispensing device 20, 1200 may dispensemedication corresponding to the audible signal. The mobile computingdevice may run according to instructions stored therein to operate andmay contain an application that communicates with the dispensing device20, 1200, e.g., so if the user dismisses a reminder on either thedispensing device 20, 1200 or the mobile computing device, the alertalso stops on the other. The drug regimen reminders can also be outputby the mobile computing device based on the dosage schedule informationthat the device knows from scanning the bottle label, writtenprescription from the pharmacy, etc. The user of the dispensing devicecan opt-in to receiving notifications or reminders that are generated bythe dispensing device and communicated to the mobile computing deviceassociated with the user. In an example embodiment, the user's mobilecomputing device is authorized by interaction with the PBM or insurancecomputing system, which can authorize use of the dispensing device andgathering information from the dispensing device. The alerts can alsoinclude feedback about missed doses. The alerts and/or reminders may beanimated or include a jingle or otherwise provide positive feedback toprovide positive reinforcement to the user. In some embodiments, areward system may be tied to medication adherence.

FIG. 17B generally illustrates the pharmacy 1706 according to theprinciples of an embodiment of the present disclosure. The pharmacy 1706may be used to process and fulfill prescriptions and prescriptionorders. After fulfillment, the fulfilled prescriptions are packed forshipping. The dispensing device 20 may be used with other pharmacysystems and the like.

The pharmacy 1706 may include devices in communication with the pharmacybenefit manager 1708, an order processing device, and/or the storagedevice, directly or over the network. Specifically, the pharmacy 1706may include pallet sizing and pucking device(s) 1712, loading device(s)1714, inspect device(s) 1716, unit of use device(s) 1718, automateddispensing device(s) 1720, manual fulfillment device(s) 1722 (which maybe fulfill environmentally controlled drugs), review devices 1724,imaging device(s) 1726, cap device(s) 1728, accumulation devices 1730,packing device(s) 1732, literature device(s) 1734, unit of use packingdevice(s) 1736 (which may be pack environmentally controlled drugs), andmail manifest device(s) 1738. Further, the pharmacy 1706 may includeadditional devices, which may communicate with each other directly orover the network.

In some embodiments, operations performed by one of these devices1712-1738 may be performed sequentially, or in parallel with theoperations of another device as may be coordinated by the orderprocessing device, which may include a dedicated processor in operablecommunication with a memory. In some embodiments, the order-processingdevice tracks a prescription with the pharmacy based on operationsperformed by one or more of the devices 1712-1738.

In some embodiments, the pharmacy may transport prescription drugcontainers, for example, among the devices 1712-1738 in the high-volumefulfillment center, by use of pallets. The pallet sizing and puckingdevice 1712 may configure pucks in a pallet. A pallet may be a transportstructure for a number of prescription containers, and may include anumber of cavities. A puck may be placed in one or more than one of thecavities in a pallet by the pallet sizing and pucking device 1712. Thepuck may include a receptacle sized and shaped to receive a prescriptioncontainer. Such containers may be supported by the pucks during carriagein the pallet. Different pucks may have differently sized and shapedreceptacles to accommodate containers of differing sizes, as may beappropriate for different prescriptions.

The arrangement of pucks in a pallet may be determined by the orderprocessing device based on prescriptions that the order processingdevice decides to launch. The arrangement logic may be implementeddirectly in the pallet sizing and pucking device 1712. Once aprescription is set to be launched, a puck suitable for the appropriatesize of container for that prescription may be positioned in a pallet bya robotic arm or pickers. The pallet sizing and pucking device 1712 maylaunch a pallet once pucks have been configured in the pallet.

The loading device 1714 may load prescription containers into the puckson a pallet by a robotic arm, a pick and place mechanism (also referredto as pickers), etc. In various embodiments, the loading device 1714 hasrobotic arms or pickers to grasp a prescription container and move it toand from a pallet or a puck. The loading device 1714 may also print alabel that is appropriate for a container that is to be loaded onto thepallet, and apply the label to the container. The pallet may be locatedon a conveyor assembly during these operations (e.g., at the high-volumefulfillment center, etc.).

The inspect device 1716 may verify that containers in a pallet arecorrectly labeled and in the correct spot on the pallet. The inspectdevice 1716 may scan the label on one or more containers on the pallet.Labels of containers may be scanned or imaged in full or in part by theinspect device 1716. Such imaging may occur after the container has beenlifted out of corresponding puck by a robotic arm, picker, etc., or maybe otherwise scanned or imaged while retained in the puck. In someembodiments, images and/or video captured by the inspect device 910 maybe stored in the storage device as order data.

The unit of use device 1718 may temporarily store, monitor, label,and/or dispense unit of use products. In general, unit of use productsare prescription drug products that may be delivered to a user or memberwithout being repackaged at the pharmacy 1706. These products mayinclude pills in a container, pills in a blister pack, inhalers,temperature-controlled drugs, etc. Prescription drug products dispensedby the unit of use device 1718 may be packaged individually orcollectively for shipping, or may be shipped in combination with otherprescription drugs dispensed by other devices in the high-volumefulfillment center.

At least some of the operations of the devices 1712-1738 may be directedby the order processing device. For example, the manual fulfillmentdevice 1722, the review device 1724, the automated dispensing device1720, and/or the packing device 1732, etc. may receive instructionsprovided by the order processing device.

The automated dispensing device 1720 may include one or more devicesthat dispense prescription drugs or pharmaceuticals into prescriptioncontainers in accordance with one or multiple prescription orders. Ingeneral, the automated dispensing device 1720 may include mechanical andelectronic components with, in some embodiments, software and/or logicto facilitate pharmaceutical dispensing that would otherwise beperformed in a manual fashion by a pharmacist and/or pharmacisttechnician. For example, the automated dispensing device 1720 mayinclude high-volume fillers that fill a number of prescription drugtypes at a rapid rate and blister pack machines that dispense and packdrugs into a blister pack. Prescription drugs dispensed by the automateddispensing devices 1720 may be packaged individually or collectively forshipping, or may be shipped in combination with other prescription drugsdispensed by other devices in the high-volume fulfillment center.

The manual fulfillment device 1722 controls how prescriptions aremanually fulfilled. For example, the manual fulfillment device 1722 mayreceive or obtain a container and enable fulfillment of the container bya pharmacist or pharmacy technician. In some embodiments, the manualfulfillment device 1722 provides the filled container to another devicein the pharmacy fulfillment devices to be joined with other containersin a prescription order for a user or member. For example,non-environmentally controlled drugs and environmentally controlleddrugs may be filled and joined together for packaging.

In general, manual fulfillment may include operations at least partiallyperformed by a pharmacist or a pharmacy technician. For example, aperson may retrieve a supply of the prescribed drug, may make anobservation, may count out a prescribed quantity of drugs and place theminto a prescription container, etc. or retrieve drugs from a cooler.Some portions of the manual fulfillment process may be automated by useof a machine. For example, counting of capsules, tablets, or pills maybe at least partially automated (such as through use of a pill counter).Prescription drugs dispensed by the manual fulfillment device 1722 maybe packaged individually or collectively for shipping, or may be shippedin combination with other prescription drugs dispensed by other devicesin the high-volume fulfillment center.

The review device 1724 may process prescription containers to bereviewed by a pharmacist for proper pill count, exception handling,prescription verification, etc. Fulfilled prescriptions may be manuallyreviewed and/or verified by a pharmacist, as may be required by state orlocal law. A pharmacist or other licensed pharmacy person who maydispense certain drugs in compliance with local and/or other laws mayoperate the review device 1724 and visually inspect a prescriptioncontainer that has been filled with a prescription drug. The pharmacistmay review, verify, and/or evaluate drug quantity, drug strength, and/ordrug interaction concerns, or otherwise perform pharmacist services. Thepharmacist may also handle containers which have been flagged as anexception, such as containers with unreadable labels, containers forwhich the associated prescription order has been canceled, containerswith defects, etc. In an example, the manual review may be performed ata manual review station.

The imaging device 1726 may image containers once they have been filledwith pharmaceuticals. The imaging device 1726 may measure a fill heightof the pharmaceuticals in the container based on the obtained image todetermine if the container is filled to the correct height given thetype of pharmaceutical and the number of pills in the prescription.Images of the pills in the container may also be obtained to detect thesize of the pills themselves and markings thereon. A temperaturecontrolled package may be imaged to ensure the correct coolant is in thepackage. The images may be transmitted to the order processing deviceand/or stored in the storage device as part of the order data.

The cap device 1728 may be used to cap or otherwise seal a prescriptioncontainer. In some embodiments, the cap device 1728 may secure aprescription container with a type of cap in accordance with a userpreference (e.g., a preference regarding child resistance, etc.), a plansponsor preference, a prescriber preference, etc. The cap device 1728may also etch a message into the cap, although this process may beperformed by a subsequent device in the high-volume fulfillment center.

The accumulation device 1730 accumulates various containers ofprescription drugs in a prescription order. The accumulation device 1730may accumulate prescription containers from various devices or areas ofthe pharmacy. For example, the accumulation device 924 may accumulateprescription containers from the unit of use device 1718, the automateddispensing device 1720, the manual fulfillment device 1722, and thereview device 1724. The accumulation device 1730 may be used to groupthe prescription containers prior to shipment to the member.

The literature device 1734 prints, or otherwise generates, literature toinclude with each prescription drug order. The literature may be printedon multiple sheets of substrates, such as paper, coated paper, printablepolymers, or combinations of the above substrates. The literatureprinted by the literature device 1734 may include information requiredto accompany the prescription drugs included in a prescription order,other information related to prescription drugs in the order, financialinformation associated with the order (for example, an invoice or anaccount statement), etc.

In some embodiments, the literature device 1734 folds or otherwiseprepares the literature for inclusion with a prescription drug order(e.g., in a shipping container). In other embodiments, the literaturedevice 1734 prints the literature and is separate from another devicethat prepares the printed literature for inclusion with a prescriptionorder.

The packing device 1732 packages the prescription order in preparationfor shipping the order. The packing device 1732 may box, bag, orotherwise package the fulfilled prescription order for delivery. Thepacking device 1732 may further place inserts (e.g., literature or otherpapers, etc.) into the packaging received from the literature device1734. For example, bulk prescription orders may be shipped in a box,while other prescription orders may be shipped in a bag, which may be awrap seal bag.

The packing device 1732 may label the box or bag with an address and arecipient's name. The label may be printed and affixed to the bag orbox, be printed directly onto the bag or box, or otherwise associatedwith the bag or box. The packing device 1732 may sort the box or bag formailing in an efficient manner (e.g., sort by delivery address, etc.).The packing device 1732 may include ice or temperature sensitiveelements for prescriptions that are to be kept within a temperaturerange during shipping (for example, this may be necessary in order toretain efficacy). The ultimate package may then be shipped throughpostal mail, through a mail order delivery service that ships via groundand/or air (e.g., UPS, FEDEX, or DHL, etc.), through a delivery service,through a locker box at a shipping site (e.g., AMAZON locker or a POBox, etc.), or otherwise to a delivery location. Some packages will bedelivered using autonomous delivery vehicles, e.g., ground vehicles oraircraft, to the delivery location.

The unit of use packing device 1736 packages a unit of use prescriptionorder in preparation for shipping the order. The unit of use packingdevice 1736 may include manual scanning of containers to be bagged forshipping to verify each container in the order. In an exampleimplementation, the manual scanning may be performed at a manualscanning station. A mail manifest device 1738 may print mailing labelsused by the packing device 1732 and may print shipping manifests andpacking lists.

Multiple devices may share processing and/or memory resources. Thedevices 1712-1738 may be located in the same area or in differentlocations. For example, the devices 1712-1738 may be located in abuilding or set of adjoining buildings. The devices 1712-1738 may beinterconnected (such as by conveyors), networked, and/or otherwise incontact with one another or integrated with one another (e.g., at thehigh-volume fulfillment center, etc.). In addition, the functionality ofa device may be split among a number of discrete devices and/or combinedwith other devices.

In FIG. 18 , the electrical system of the dispensing device 1200 isschematically illustrated. As shown, the dispensing device 1200 includesa microprocessor 1800 (e.g., which may be referred to herein as theprocessor 1800), which is in electrical communication with a memory 1802so that the processor 1800 can read from and write to the memory 1802.The processor 1800 may include any suitable processor, such as thosedescribed herein. Additionally, or alternatively, the dispensing device1200 may include any suitable number of processors in addition to theprocessor 1800. The memory 1802 may comprise a single disk or aplurality of disks (e.g., hard drives), and includes a storagemanagement module that manages one or more partitions within the memory1802. In some embodiments, memory 1802 may include flash memory,semiconductor (solid state) memory or the like. The memory 1802 mayinclude Random Access Memory (RAM), a Read-Only Memory (ROM), or acombination thereof. The memory 1802 is preferably of the non-volatiletype such that the data stored thereon is not lost in the event of apower failure in the dispensing device 20, 1200. The memory 1802 mayinclude instructions that, when executed by the processor 1800, causethe processor 1800 to, at least, control various aspects the dispensingdevice 100.

The memory 1802 contains data which includes: (1) which medications arecontained in the dispensing device 1200, e.g., in the bottles 40 on thecarousel 42, in the plastic pouches 1202, and in the pill cups 1204, (2)the medication counts for each of these medications, (3) an automaticdispensing schedule (which can be adjusted by the user, the pharmacy1706, or the pharmacy benefit manager 1708), (4) a log containing timestamps of all dispensing events, (5) an updateable database ofpredictive models to be accessed when confirming the contents of acontainer 40, 1202, 1204, and (6) additional health data related to theuser (for example, data uploaded to the dispensing device 1200 from awearable device 1711, such as a smart watch or a glucose monitor). Thedispensing device 1200 is preferably powered by alternating current (AC)from a wall outlet as its primary power source but contains a batterybackup so that operation continues in the event of a loss of power fromthe primary power source. The dispensing device 20, 1200 furtherincludes a wireless module 1804, which allows the dispensing device 1200to connect with the internet router 1702 and/or external device 24.

The predictive models can be built and maintained outside of thedispensing device 20, e.g., in pharmacy systems or medical systems, andcan be refreshed periodically using stored data. The dispensing device20 includes an inspection zone to produce inputs to the predictionmodel. The inputs can include a label image, at least one bar codes,scan codes, multiple photo and sonographic images of contents, and netweight.

The dispensing device 20, 1200 is also preferably provided with asecurity system, which must be cleared prior to dispensing one or moretypes of pills 22 contained therein. The security system relies on apositive identification of the user through one or more of a personalidentification number (PIN), thumbprint, facial recognition, a mobilephone app, a card reader, a Universal Serial Bus (USB) token, aRivest-Shamir-Adleman (RSA) token, etc. The security system can alsoutilize on one or more sensors in a user's mobile device, such as theexternal device 24, to establish the positive identification. That is,before a medication is dispensed, the dispensing device 20, 1200 cancommunicate with the external device 24 which, in turn, will require theuser to verify the user's identity through, for example, a fingerprintsensor or a facial identification sensor built into the external device24.

The dispensing device 20, 1200 may also contain medications for multipleusers, e.g., different members of a family. In use, the dispensingdevice 20, 1200 may validate which user is interacting with thedispensing device 20, 1200 through a number of different means. Forexample, in some embodiments, the security system of the dispensingdevice 20, 1200 can validate which user is interacting with thedispensing device 20, 1200 using a positive identification means. Inother embodiments, the user can be validated by the selecting a userprofile and entering a passcode or password on the first display screen36 or through a positive voice identification through either themicrophone 34 or through the voice assistant 1810.

In some embodiments, the dispensing device 20, 1200 may include one ormore sensors configured to measure or sense various aspects of thedispensing device 20, 1200 and/or an environment external to thedispensing device 20, 1200. For example, the dispensing device 20, 1200,may include a motion sensor, or other suitable sensor, configured todetect motion proximate to the dispensing device 20, 1200. The processor1800 may receive data from the sensor and may illuminate a lightassociated with the dispensing tray 28 in response to the detectedmotion.

In some embodiments, the dispensing device 20, 1200 may include one ormore vital measurement devices. For example, the dispensing device 20,1200 may include a pulse monitor, a blood pressure cuff (e.g., of othersuitable blood pressure measuring device), a thermometer (e.g. atouchless thermometer or other suitable thermometer), other suitablevital measurement devices, or a combination thereof. The user mayinteract with the one or more vital measurement devices. For example,the user may use a pulse monitor to measure the user's pulse. Theprocessor 1800 may receive a pulse measurement from the pulse monitorindicating the user's pulse. The processor 1800 may store the pulsemeasurement in user measurements table or database (herein afterreferred to as the user measurement data). The user measurements datamay be stored on the memory 1802, on a cloud computing device, on amobile computing device of the user, or other suitable location. Forexample, the processor 1800 may store and/or update the usermeasurements data in the memory 1802. Additionally, or alternatively,the processor 1800 may communicate with a suitable cloud computingdevice, remotely located server, mobile computing device, or othersuitable remotely located computing device to store and/or update theuser measurements data.

In some embodiments, the user may interact with a blood pressuremeasuring device of the dispensing device 20, 1200. The user may use theblood pressure measuring device to measure a blood pressure of the user.The processor 1800 may receive a blood pressure measurement from theblood pressure measuring device indicating the blood pressure of theuser. The processor 1800 may update the user measurements data toinclude the blood pressure measurement.

In some embodiments, the user may interact with a thermometer of thedispensing device 20, 1200. The user may use the thermometer to measurea temperature of the user. The processor 1800 may receive a temperaturemeasurement from the thermometer indicating the user's temperature. Theprocessor 1800 may update the user measurement data to include thetemperature measurement. It should be understood that the dispensingdevice 20, 1200 may include any suitable measuring device that the usermay interact with to provide measurement data corresponding to the user.

In some embodiments, the user may interact with a keyboard, touchscreen, or other suitable input device to provide various measurements(e.g., pulse measurement, blood pressure measurement, temperaturemeasurement, insulin measurement, other suitable measurements, or acombination thereof). For example, the user may interact with a touchscreen on the dispensing device 20, 1200 to provide various measurementsto the dispensing device 20, 1200. In some embodiments, the user mayinteract with an application on a corresponding mobile computing device.The user may provide user measurement data using the application. Theapplication may communicate the user measurement data, using the mobilecomputing device, to the dispensing device 20, 1200. The processor 1800may store and/or update the user measurement data, based on the receivedvarious measurements.

In some embodiments, the processor 1800 may be configured to communicatethe user measurement data to a pharmacist and/or medical provider. Thepharmacists and/or medical provider may review the user measurement dataand determine whether to adjust one or more medication doses taken bythe user. The pharmacist and/or medical provider may, using a suitablecomputing device, communicate an adjusted medication dose to thedispensing device 20, 1200. The dispensing device 20, 1200 may adjust adispensing amount for the medication based on the adjusted dose for themedication.

In some embodiments, the dispensing device 20, 1200 may be configured tocommunicate with other devices on the same network or within a range ofthe dispensing device 20, 1200. As described, the dispensing device 20,1200 may include the wireless module 1804. The wireless module 1804 mayinclude any suitable wireless communications device include a wirelessfidelity (WiFI) communications device, a Bluetooth device, a near fieldcommunications device, any other suitable wireless communicationsdevice, or a combination thereof. The wireless module 1804 maycommunicate with a network, such as a Local Area Network, a Wide AreaNetwork, the Internet, and/or other suitable networks. The wirelessmodule 1804 may communicate with the network via the router 1702.

In some embodiments, the processor 1800, using the wireless module 1804,may identify other devices on the network. For example, the processor1800 may identify devices on the network operating according to the samecommunications protocol. The other device may include Internet of Things(IoT) enabled devices, such as a coffee maker, a refrigerator, a smartswitch, a smart light, an alarm clock, other suitable devices, or acombination thereof. The processor 1800 may identify behavioral patternsof the user based on communications with the other devices on thenetwork. For example, the user may start a coffee maker, open arefrigerator, turn on one or more lights, turn off an alarm clock, andthe like.

The processor 1800 may adjust a dispensing schedule of medications inthe dispensing device 20, 1200 based on an identified behavioralpattern. For example, the dispensing device 20, 1200 may dispensemedications in the dispensing device 20, 1200 to the dispensing tray 28at a time that corresponds to the user being within a range of thedispensing device 20, 1200. The processor 1800 may identify the timethat corresponds to the using being within the range of the dispensingdevice 20, 1200 based on the identified behavioral pattern.

In some embodiments, the processor 1800 may determine whether variousmedications dispensed by the dispensing device 20, 1200 and consumed bythe user have adverse effects on the user. For example, the processor1800 identify a sudden change in the behavioral pattern of the user anddetermine that one or more medications may be contributing to the changein behavioral patterns. For example, the processor 1800 may be incommunication with a machine learning mechanism configured to identifybehavioral changes corresponding to potential side effects of certainmedications. The processor 1800 may generate an indication (e.g. such asa message or other suitable indication) indicating that the user may beexperience side effects from one or more medications. The processor 1800may communicate, using the route 1702, the indication to pharmacistand/or medical provider. The pharmacist and/or medical provider maycontact the user and/or may adjust one or more doses of medicationsbeing consumed by the user.

In some embodiments, the dispensing device 20, 1200 may dispense amultiple day supply of medications in response to a request by the user.For example, the user may provide an input to the dispensing device 20,1200 using any suitable input. For example, the demand may be input tothe dispensing device 20, 1200 by a physical interaction by the userwith the touch screen, by an interaction between the user and theexternal device, by an audible demand by the user that is sensed by themicrophone of the dispensing device 20, 1200, or by a user's thoughtthat is captured by a device implanted in or otherwise in communicationwith the user's brain.

The user may also demand a quantity of pills for a time period that theuser will be away from the dispensing device 20, 1200, e.g., before theuser goes on vacation, on a work trip, in the hospital, or any othersuitable reason. For example, the user may be taking a trip and will notbe near the dispensing device 20, 1200 for the period. The user mayprovide the dispensing device 20, 1200 with a number of days that theuser will be away from the dispensing device 20, 1200. The processor1800 may receiving the number of days and determine a quantity of eachof the various medications taken by the user for the number of days. Theprocessor 1800 may dispense the quantity of each of the variousmedications.

In some embodiments, the processor 1800 may dispense a single day supplyof medication into the plastic pouches 1202, as described. In someembodiment, the processor 1800 may communicate with a pharmacist and/ormedical provider indicating that the user has requested the multiple daysupply of medication. The pharmacist and/or medical provider maydetermine whether to allow the dispensing device 20, 1200 to dispensethe multiple day supply. The processor 1800 may receive an indicationfrom the pharmacists and/or medical providing instructing the dispensingdevice 20, 1200 to dispense the multiple day supply. In response to theprocessor 1800 receiving instructions from the pharmacist and/or medicalprovider indicating not to dispense the multiple day supply, theprocessor 1800 may provide to the user (e.g., via the touch screen,communication via the mobile device, or any suitable mechanism),indicating to the user to contact the pharmacist and/or medicalprovider.

In some embodiments, the processor 1800 may be configured to communicatewith a calendaring application associated with the user. For example,the user may utilize a calendaring application on the mobile device orany suitable computing device. The processor 1800 may identify travelplans stored in the calendaring application indicating that the user maybe away from the dispensing device 20, 1200 for a period. The processor1800 may generate a request to a pharmacist and/or medical providerindicating that the user may be away from the dispensing device 20,1200. The request may request that the pharmacist and/or medicalprovider contact the user. In some embodiments, the processor 1800 maydispense a multiple day supply in response to identifying travel plansin the user's calendaring application.

In some embodiments, the processor 1800 may identify scheduled events inthe calendaring application. For example, the processor 1800 mayidentify scheduled events that begin prior to a normal dispensing time.The processor 1800 may determine to dispense the mediations to thedispensing tray 28 prior to the identified scheduled event (e.g. suchthat the user does not leave the proximity of the dispensing device 20,1200 prior to the mediations being dispensed).

In some embodiments, the processor 1800 may be configured to verify theidentity of the user. The processor 1800 may be configured to receivevarious biometric data of the user, such as a facial scan, retina scan,fingerprints, and the like. For example, the processor 1800 may receiveor retrieve a file that contains the facial recognition data and compareit to the image data captured by an image capturing device. The imagecapturing device may include a camera be disposed on the dispensingdevice 20, 1200, a camera associated with the mobile device, or anyother suitable image capturing device. The processor 1800 may comparethe facial recognition data with the image data using facial recognitionsoftware. The processor 1800 may verify the user's identify in responseto a determination that the facial recognition data matches the imagedata.

In some embodiments, the dispensing device 20, 1200 may include amicrophone or other suitable audible input device. The user may providean audible input (e.g. by speaking, providing a tone generated by anapplication associated with the pharmacy 1706 on the mobile device, orother suitable audible input). The processor 1800 may compare theaudible input to a corresponding stored file (e.g., a similar audibleinput, such as a sample of the speech of the user, a corresponding tone,or other suitable audible data or other suitable data). The processor1800 may verify the identity of the user based on a determination thatthe audible input matches the corresponding file.

In some embodiments, the processor 1800 may receive one or morefingerprints scans of the user, using the fingerprint input deviceassociated with the dispensing device 20, 1200, a fingerprint inputdevice associated with the mobile device, or other suitable fingerprintinput device. The processor 1800 may verify the identity of the user bycomparing the fingerprint scans with stored fingerprints associated withthe user. In some embodiments, the processor 1800 may scan one or moreretinas of the recipient. For example, the processor 1800 may receiveone or more retina scans from a retina scanner disposed on thedispensing device 20, 1200, a retina scanner associated with the mobiledevice, or any other suitable retina scanner or retina scanning device.The processor 1800 may compare the one or more retina scans with storedretina scans corresponding to the user. The processor 1800 may verifythe identity of the user in response to a determination that thereceived retina scans match the stored retina scans corresponding to theuser.

In some embodiments, the dispensing device 20, 1200 may be configured toscan a quick response (QR) code or barcode of the associated with theuser. For example, the user may receive a QR code or a barcode from thepharmacy application, an SMS message, a text message, an email, a phonecall, or other suitable QR code source. The user may print the QR codeor barcode or the user may present the QR code or the barcode on themobile device.

The processor 1800 may scan, using an image capturing device disposed onthe dispensing device 20, 1200, the QR code or the barcode. Theprocessor 1800 may compare the scanned QR code and/or barcode to QR codeand/or barcode stored on the memory 1802 or other suitable location. TheQR code and/or barcode stored on the memory 1802 or other suitablelocation may be generated by the processor 1800. For example, theprocessor 1800 may generate the QR code and/or barcode stored on thememory 1802 or other suitable location and the QR code and/or barcodereceived by the user. In some embodiments, the processor 1800 mayreceive the QR code and/or barcode from the pharmacy application. Theprocessor 1800 may verify the identify of the user in response to the QRcode and/or barcode presented by the user matching the QR code and/orbarcode stored on the memory 1802 or other suitable location.

In some embodiments, the processor 1800 may receive a numeric value fromthe user (e.g., via a keypad input, a touch screen, or other suitableinput device, such as those described herein). For example, the user mayreceive a numeric value from the via the pharmacy application. The usermay provide or input the numeric value to the dispensing device 20,1200. The processor 1800 may verify the identity of the user based on acomparison of the numeric value to a numeric value communicated to theprocessor 1800 by via the pharmacy application. It should be understoodthat the processor 1800 may receive any other suitable information fromthe user in addition to or instead of those described herein that theprocessor 1800 may user to verify the identity of the user.

In some embodiments, the processor 1800 may be configured to perform themethods described herein. In some embodiments, the processor 1800 maycommunicate with various other devices, such as mobile computingdevices, networks, cloud computing devices, remotely located servers,and the like to perform the methods described herein.

Referring now to FIG. 19 , a flow chart illustrates an exemplary methodof inserting a bottle 40 into the dispensing device 20, 1200 andautomatically determining and verifying the contents of the bottle 40.At step 1900, the bottle 40 is manually inserted into the carousel 42 inan upside-down orientation with the cap 44 being received within one ofthe openings of the carousel 42. At step 1902, the carousel 42 isautomatically rotated to bring the bottle 40 into the inspection zone46. At step 1904, the bottle 40 is lifted by the agitator 60 and thetotal weight of the bottle 40 and the pills 22 contained therein ismeasured. At step 1906, the outer surface of the bottle 40 is scannedfor a code and/or label identifying the contents of the bottle 40. Atstep 1908, the cameras 68 and ultrasound sensor 58 are activated to scanthe pills 22 inside the bottle 40. At step 1910, the results of thescanning (i.e., the photographs captured by the cameras and the sonogramgenerated by the ultrasound sensor) are compared against the database todetermine the type of pill 22 in the bottle 40. At decision step 1912,the dispensing device 20, 1200 decides if it is able to determine thetype of pills 22 in the bottle 40 based on the results of the scanningof the outer surface of the bottle 40 and of the pills 22 located in thebottle 40.

If the answer to decision step 1912 is no, then at step 1914, theagitator 60 is activated to shake up the contents of the bottle 40, andat step 2016, the cameras 50 and ultrasound sensor 58 are re-activatedto scan the pills 22 inside the bottle 40 before proceeding back to step1910. If the loop of steps 1910-1916 is repeated a predetermined numberof times (e.g., five) and the type of pill 22 still cannot bedetermined, then the bottle 40 is rejected by the dispensing device 20,1200 and an alert is given to the user, e.g., an audible alert isbroadcast through the speaker 32 or a visual alert is displayed on thefirst or second display screens 36, 38 or on the user's external device24.

If the answer to decision step 1912 is yes, then at step 1918, the scans(photographs and sonogram) are uploaded to the artificial intelligencecloud database to improve the future verification process for not justthe user's dispensing device 20, 1200 but also for other users'dispensing devices. At step 1920, the pill count is verified based on acalculation which includes the weight measurement of the bottle 40during step 1904, a known pill weight (from the database), and a knownempty bottle weight (from the database). At step 1922, the dispensingdevice 20 stores data pertaining to the contents of the bottle 40,including both the type of medication and the pill count, in the memory1802.

Referring now to FIG. 20 , a flow chart depicting an exemplary method ofdispensing one or more pills 22 from a bottle 40 in the dispensingdevice 20, 1200 is shown. At step 2000, the dispensing device 20, 1200receives an instruction to dispense one or more pills 22 from one of thebottles 40 in the carousel 42 of the dispensing device 20, 1200. Theinstructions could be an on-demand request for a pill 22 from a user orthey could be according to a predetermined schedule. At step 2002, thesecurity system verifies a user's identity using a verification process,such as one of the verification processes discussed above. At step 2004,the carousel 42 is rotated to bring the bottle 40 containing therequested pill(s) 22 into the dispensing zone 48. At step 2006, thedrive wheel 62 is activated to rotate the bottle 40 such that one ormore pills 22 are dispensed through the cap 44 and into the staging zone64 of the dispensing device 20, 1200. At step 2008, the pill(s) 22 arevalidated using the camera 68 in the staging zone 64. At decision step2010, it is determined if the pills(s) 22 match the requested pills 22.If the answer to decision step 2010 is yes, then at step 2012, the gate66 is opened to release the pill(s) 22 to the dispensing tray 28. If theanswer to decision step 2010 is no, then at step 2014, the pill(s) 22is/are rejected by the dispensing device 20, 1200, and an alert isprovided to the user, e.g., an audible alert through the speaker 32 or avisual alert on the first or second display screens 36, 38 or on theuser's external device 24.

Referring now to FIG. 21 , a flow chart depicting an exemplary method ofdispensing one or more pills 22 from a pill cup 1204 in the dispensingdevice 1200 is shown. At step 2100, the dispensing device 1200 receivesan instruction to dispense the contents of one of the pill cups 1204inside the dispensing device 1200. The instructions could be anon-demand request for a pill 22 from a user or they could be accordingto a predetermined schedule.

At step 2102, the security system verifies a user's identity using averification process, such as one of the verification processesdiscussed above. At step 2104, the picking mechanism 1216 is actuated toengage and lift the pill cup 1204 out of the tray 1214.

At step 2106, the pills 22 are released into the staging zone 64. Step2106 could involve, for example, dropping the full pill cup 1204 intothe staging zone 64, cutting an opening into the pill cup 1204 to onlydrop the pills 22 into the staging zone 64, or removing a lid 1300 fromthe pill cup to only drop the pills 22 into the staging zone 64. Thecutter could cut the top, bottom, or a side wall of the pill cup 1204 torelease the pills 22. At step 2108, the pill(s) 22 are validated usingthe camera 68 in the staging zone 64. At decision step 2110, it isdetermined if the pills(s) 22 match the requested pills 22. If theanswer to decision step 2110 is yes, then at step 2112, the gate 66 isopened to release the pill(s) 22 to the dispensing tray 28. If theanswer to decision step 2110 is no, then at step 2114, the pill(s) 22is/are rejected by the dispensing device 1200, and an alert is providedto the user, e.g., an audible alert through the speaker 32 or a visualalert on the first or second display screens 36, 38 or on the user'sexternal device 24.

Referring now to FIG. 22 , a flow chart depicting an exemplary method ofdispensing one or more pills 22 from a plastic pouch 1202 in thedispensing device 1200 is shown. At step 2200, the dispensing device1200 receives an instruction to dispense the contents of one of theplastic pouches 1202 inside the dispensing device 1200. The instructionscould be an on-demand request for a pill 22 from a user or they could beaccording to a predetermined schedule. At step 2202, the security systemverifies a user's identity using a verification process, such as one ofthe verification processes discussed above. At step 2204, the wind-upspool 1208 is activated to advance the requested plastic pouch 1202until it is located directly over the staging zone 64. At step 2206, thecutting device 1210 is activated to cut an opening into the plasticpouch 1202 to drop the pills 22 into the staging zone 64. At step 2208,the pill(s) 22 are validated using the camera 68 in the staging zone 64.At decision step 2210, it is determined if the pills(s) 22 match therequested pills 22. If the answer to decision step 2210 is yes, then atstep 2212, the gate 66 is opened to release the pill(s) 22 to thedispensing tray 28. If the answer to decision step 2210 is no, then atstep 2314, the pill(s) 22 is/are rejected by the dispensing device 1200,and an alert is provided to the user, e.g., an audible alert through thespeaker 32 or a visual alert on the first or second display screens 36,38 or on the user's external device 24.

Referring back to FIG. 17A, the PBM device or the payor device canoperate a predictive model to improve adherence of an individual user ofthe dispensing device based on data from a group of dispensing devicesout in the field combined with data generated in the lab controlled bythe payor or the PBM. The sensors in the dispensing devices can feeddata back to a database. This data can train or validate a predictivemodel, which can be generated using machine learning. The predictivemodel can operate to predict and to validate the contents and count ofitems in the containers. All of the dispensing devices can providefeedback to further refine the predictive model. The predictive modelcan also operate on a medication type to determine if there are moreadherence issues based on type of drug in conjunction with or separatefrom the type of user of the dispensing device. The ability ofdispensing device to reproduce the exact conditions in the predictionenvironment (local) as were used in the training environment (remote),such as lighting and bottle positioning, will improve the accuracy ofpredictions in the predictive model.

The dispensing device may be configured to communicate directly withmedical care providers (such as a doctor, a nurse, or a pharmacist)and/or allow the user to communicate with a medical care providerdirectly. The direct communication between the user and the medical careprovider may be a telehealth appointment with audio and/or videodisplayed on the touch screen. This may allow the user to order and/orprocess a refill of a medication or order a new medication to beinserted into the dispensing device. The dispensing device mayautomatically schedule such a telehealth appointment based on anysuitable factor, e.g., when the quantity of a medication in thedispensing device falls below a threshold. During the telehealthappointment, the dispensing device can provide data to the medical careprovider. The data can include data from the user's wearable device(s),such as a smart watch or a glucose monitor, and/or information about anyrecently missed doses of medication. For example, using the actualdevice using its agitation functionality to agitate of the bottlecontents in addition to taking multiple reads for prediction provides alow-cost method at model training time to automate the obtaining ofmultiple images (as many as needed by the training algorithm) withpills/contents rearranged after each agitation, to train predictivemodels.

The above discussion is meant to be illustrative of the principles andvarious embodiments of the present disclosure. Numerous variations andmodifications will become apparent to those skilled in the art once theabove disclosure is fully appreciated. It is intended that the followingclaims be interpreted to embrace all such variations and modifications.

The word “example” is used herein to mean serving as an example,instance, or illustration. Any aspect or design described herein as“example” is not necessarily to be construed as preferred oradvantageous over other aspects or designs. Rather, use of the word“example” is intended to present concepts in a concrete fashion. As usedin this application, the term “or” is intended to mean an inclusive “or”rather than an exclusive “or.” That is, unless specified otherwise, orclear from context, “X includes A or B” is intended to mean any of thenatural inclusive permutations. That is, if X includes A; X includes B;or X includes both A and B, then “X includes A or B” is satisfied underany of the foregoing instances. In addition, the articles “a” and “an”as used in this application and the appended claims should generally beconstrued to mean “one or more” unless specified otherwise or clear fromcontext to be directed to a singular form. Moreover, use of the term “animplementation” or “one implementation” throughout is not intended tomean the same embodiment or implementation unless described as such.

Implementations of the systems, algorithms, methods, instructions, etc.,described herein may be realized in hardware, software, or anycombination thereof. The hardware may include, for example, computers,intellectual property (IP) cores, application-specific integratedcircuits (ASICs), programmable logic arrays, optical processors,programmable logic controllers, microcode, microcontrollers, servers,microprocessors, digital signal processors, or any other suitablecircuit. In the claims, the term “processor” should be understood asencompassing any of the foregoing hardware, either singly or incombination. The terms “signal” and “data” are used interchangeably.

As used herein, the term module may include a packaged functionalhardware unit designed for use with other components, a set ofinstructions executable by a controller (e.g., a processor executingsoftware or firmware), processing circuitry configured to perform aparticular function, and a self-contained hardware or software componentthat interfaces with a larger system. For example, a module may includean application specific integrated circuit (ASIC), a Field ProgrammableGate Array (FPGA), a circuit, digital logic circuit, an analog circuit,a combination of discrete circuits, gates, and other types of hardwareor combination thereof. In other embodiments, a module may includememory that stores instructions executable by a controller to implementa feature of the module.

Further, in one aspect, for example, systems described herein may beimplemented using a special purpose computer/processor may be utilizedwhich may contain hardware for carrying out any of the methods,algorithms, or instructions described herein. The hardware may become aspecial purpose device when storing instructions, loading instructions,or executing instructions for the methods and/or algorithms describedherein.

Further, all or a portion of implementations of the present disclosuremay take the form of a computer program product accessible from, forexample, a computer-usable or computer-readable medium. The programincludes steps to perform, at least, portions of the methods describedherein. A computer-usable or computer-readable medium may be any devicethat can, for example, tangibly contain, store, communicate, ortransport the program for use by or in connection with any processor.The medium may be, for example, an electronic, magnetic, optical,electromagnetic, or a semiconductor device. Other suitable mediums arealso available.

At least some example embodiments of the present disclosure can addresshuman errors in adhering to the treatment regimen. This may reduce theoccurrences of adverse events, e.g., overdoses, health danger,complications and possibly deaths, health danger and deaths due to It isbelieved that some tech-savvy patients have a decreased adherence to adrug treatment regimen. Some embodiments may assist the tech-savvypatients with their adherence.

The above-described embodiments, implementations, and aspects have beendescribed in order to allow easy understanding of the present disclosureand do not limit the present disclosure. On the contrary, the disclosureis intended to cover various modifications and equivalent arrangementsincluded within the scope of the appended claims, which scope is to beaccorded the broadest interpretation to encompass all such modificationsand equivalent structure as is permitted under the law.

What is claimed is:
 1. A medication dispensing assembly for dispensingmedications from at least one medication bottle to a user, comprising: ahousing having an interior; a medication bottle including a receptacleand a cap assembly and disposed in said interior with said cap assemblyfacing vertically downwardly; said cap assembly comprising at leastthree pieces including an outer piece and a middle piece and an innerpiece, said outer and inner pieces being fixed with one another, saidmiddle piece being fixed with said receptacle, and each of said outerand middle and inner pieces of said cap assembly having at least onemedication opening; a drive unit disposed in said interior of saidhousing and configured to engage said receptacle of said medicationbottle to rotate said receptacle and said middle piece of said capassembly relative to said outer and inner pieces of said cap assemblyand about an axis which extends through said medication bottle; and saidat least one medication opening in said outer piece of said cap assemblybeing circumferentially offset from said at least one medication openingin said inner piece such that rotation of said receptacle and saidmiddle piece causes individual pills to travel first from saidreceptacle into said at least one medication opening of said innerpiece, then into said at least one medication opening of said middlepiece, then around said axis, and then outside of said cap assemblythrough said at least one medication opening of said outer piece.
 2. Themedication dispensing assembly as set forth in claim 1 further includinga carousel disposed in said interior of said housing and having aplurality of openings and said cap assembly being received in one ofsaid openings.
 3. The medication dispensing assembly as set forth inclaim 2 wherein said axis is a bottle axis and further including acarousel which is disposed in said interior of said housing and isrotatable about a carousel axis which is spaced from and parallel withsaid bottle axis to move said medication bottles through a plurality ofzones within said interior of said housing.
 4. The medication dispensingassembly as set forth in claim 3 further including a plurality ofmedication bottles and a plurality of cap assemblies received in saidplurality of openings of said carousel.
 5. The medication dispensingassembly as set forth in claim 3 wherein one of said zones is adispensing zone and wherein said drive unit includes at least one drivewheel which is configured to engage with and rotate said receptacle todispense the medication.
 6. The medication dispensing assembly as setforth in claim 3 wherein one of said zones is an inspection zone with atleast one sensor that is configured to analyze said medication bottle toautomatically determine a contents of said medication bottle.
 7. Themedication dispensing assembly as set forth in claim 1 further includinga staging zone positioned to receive medications dispensed from said atleast one cap assembly.
 8. The medication dispensing assembly as setforth in claim 7 wherein said staging zone includes at least one sensorand at least one gate and wherein said gate is configured to only opento allow the medications in said staging zone to be dispensed out ofsaid housing in response to a confirmation that the medications in saidstaging zone have been requested by a user.
 9. The medication dispensingassembly as set forth in claim 7 further including a medicationpackaging including a plurality of pouches containing medications, saidmedication packaging extending over said staging zones, and a cuttingdevice for opening said pouches to dispense the medications contained insaid pouches into said staging zone.
 10. The medication dispensingassembly as set forth in claim 7 further including: a plurality of pillcups disposed in said interior of said housing and containingmedications; and a picking mechanism configured to engage individualones of said pill cups and dispense the medications contained in saidpill cups into said staging zone.